The scene of a woman giving birth on the pavement revealed the report card of the health system: Dr. Karki

26 Bhadau, Kathmandu.

National Independent Party MP Toshima Karki stated that the incident of a woman having to give birth on the pavement near Gajendra Narayan Singh Hospital in Saptari raised serious questions about Nepal’s maternal services and overall health system.

Speaking at the House of Representatives meeting on Friday, Karki stated that despite pride in institutional delivery being free in Nepal, the Mother Safety Program (Aama Suraksha Karyakram) being operational, and maternal mortality declining, there are significant problems in the healthcare services citizens receive in practice.

She said, ‘We boast that institutional delivery is free in Nepal, there is the Mother Safety Program, and maternal mortality is decreasing. Even transportation incentive expenses are provided. But the sight of a mother having to give birth on the pavement near Gajendra Narayan Singh Hospital, which is a federal government hospital, has presented us with the report card of our maternal services and overall health system.’

She stated that even though the right to health, safe motherhood, and reproductive health are ensured in the constitution, there is a huge gap between the free services written on paper and the services citizens receive in practice.

She emphasized that immediate triage and emergency clinical assessment should begin for women arriving at the hospital in labor pain, and maternal-fetal evaluation should also be done immediately. She stated that women arriving at the hospital in labor pain should be admitted immediately and kept under continuous monitoring.

She questioned that not searching for a patient who was admitted to the hospital but went missing, and not contacting the family, constituted serious negligence.

Karki said that the hospital should be responsible for safely admitting women who arrive for delivery, transporting them if necessary, and continuously monitoring them. She stated that if a patient is not found in their bed, a search should be conducted, and immediate contact should be made via the phone number provided on the form.

She said that even in situations where there is no money for blood tests, the social service unit and the Mother Safety Program should be immediately activated. She stated that the Mother Safety Program should not be limited only to the childbirth process.

Mentioning that the Ministry of Health has initiated an investigation into the incident and a team from the Nepal Medical Council has also arrived, Karki stated that the investigation should not be limited to identifying the culprits and taking action. She emphasized that solutions should also be advanced to prevent such incidents from recurring in the future.

Similarly, she demanded that the Mother Safety Program be organized as a ‘complete maternal package.’ She stated that the program should cover services including necessary check-ups, medicines, treatment, ultrasound, postnatal care, and family planning, along with maternity and infant services.

She stated that in such a situation, the Mother Safety Program cannot be effective, pointing out that some hospitals do not provide medicines free of charge and levy fees for services such as ultrasound.

She also demanded that social service units in every hospital be kept active 24 hours a day.

She stated that the situation where poor patients have to raise money themselves or seek help should be ended, and a system should be developed where hospitals identify financially weak patients and provide necessary assistance.

Karki also demanded the establishment of a detailed ‘Maternal Care Audit’ system in every hospital, along with its regular regulation and necessary action. She stated that not only statistics on how many patients arrived, how many delivered, and how many operations were performed should be included in records and evaluation, but also details such as when the patient arrived at the hospital, whether triage was performed, and how the treatment process progressed.

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